New CGHS Guidelines: The central government has released new treatment rates for around 2,000 medical procedures and tests under the CGHS (Central Government Health Scheme) for its employees and pensioners – the biggest revision in price list in about 15 years. These new rates will be effective from October 13, 2025, and will directly impact millions of beneficiaries receiving treatment at CGHS-empanelled and non-empanelled hospitals across the country.
New rates for super-specialty hospitals
According to the new guidelines, treatment rates at super-specialty hospitals will now be 15% higher than those at NABH-accredited hospitals. This means that if a super-specialty treatment at an NABH-accredited hospital in a city costs Rs 1 lakh, the same treatment at a super-specialty hospital will now cost Rs 1.15 lakh.
This increase will apply to hospitals that fall under the super-specialty category — such as those providing high-end services like cardiology, neurosurgery, oncology, and nephrology.
What are NABH and NABL?
NABH is an accreditation body for hospitals and healthcare providers, focusing on patient safety, quality of care, and ethical practices. NABL is a separate accreditation body for testing, calibration, and medical laboratories, ensuring technical competence and quality in laboratory testing and diagnostic services. Both bodies come under the Quality Council of India (QCI).
Where will the new rates apply?
The new rates will apply to the following:
Services provided at all CGHS-affiliated Healthcare Organisations (HCOs).
Medical reimbursement claims (serving employees, pensioners, and other eligible categories).
Cashless treatment (credit treatment) will continue for CGHS pensioners and other eligible categories.
The complete list of new rates is available on the official CGHS website at https://cghs.mohfw.gov.in.
Difference in CGHS rates by city
The government has divided the rates according to the classification of cities —
Rates in Tier-1 cities will be considered standard.
Rates in Tier-2 cities will be 10% lower.
Rates in Tier-3 cities will be 20% lower.
(These rates will also apply to hospitals in the North-Eastern states, Jammu and Kashmir, and Ladakh.)
Changes in rates by ward for CGHS beneficiaries
New rates have been fixed for semi-private wards.
Rates for general wards will be 5% lower.
Rates for private wards will be 5% higher.
Furthermore, rates for consultations, radiotherapy, day care, and minor procedures will remain the same for all ward categories.
Impact on NABH and NABL hospitals
Hospitals that are not NABH/NABL accredited will have rates 15% lower than accredited hospitals.
If a patient receives treatment from a non-empanelled hospital, reimbursement will be limited to non-NABH rates.
What will be the impact on cancer treatment?
Cancer surgery rates will remain at the old CGHS rates for now.
However, new rates will now apply for chemotherapy, investigations, and radiotherapy.
Hospitals will have to re-empanel
The government has clarified to all hospitals that all MoA (Memoranda of Agreement) prior to October 13, 2025, will no longer be valid.
All empanelled hospitals will have to re-apply for empanelment under the new guidelines.
Hospitals will have to submit an undertaking before October 13, stating their acceptance of the new terms and conditions.
Hospitals that do not submit the undertaking on time will be automatically de-empanelled.
Relief for CGHS beneficiaries
The new rates and guidelines aim to ensure better and transparent healthcare for government employees and pensioners.
Increasing the rates for super-specialty hospitals will provide patients with more options and make high-quality healthcare readily available.
Summing up:
The new CGHS rates will be effective from October 13, 2025.
Super-specialty hospital rates will be 15% higher.
Rates for Tier-II and Tier-III cities will be reduced by 10% and 20%, respectively.
The new rates will apply equally to all CGHS pensioners and employees.